IJE Advance Access published online on February 8, 2009
International Journal of Epidemiology, doi:10.1093/ije/dyn374
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Lung function in mid-life compared with later life is a stronger predictor of arterial stiffness in men: The Caerphilly Prospective Study
1Department of Respiratory Medicine, School of Medicine, Cardiff University, Cardiff, South Wales, UK.
2Wales Heart Research Institue, School of Medicine, Cardiff University, Cardiff, South Wales, UK.
3Department of Clinical Pharmacology, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
4London School of Hygiene and Tropical Medicine, University of London, London, UK.
5Department of Epidemiology, Statistics and Public Health, Centre for Health Sciences Research, Cardiff University, Cardiff, UK.
6Department of Social Medicine, University of Bristol, Bristol, UK.
* Corresponding author. Department of Respiratory Medicine, School of Medicine, Cardiff University, Academic Centre, Llandough Hospital, Penlan Road, Cardiff CF64 2XX, South Wales, UK. E-mail: boltonce{at}cf.ac.uk
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Abstract |
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Background Increased arterial stiffness predicts future cardiovascular disease and in some cross-sectional studies it is related to worse lung function and obstructive pulmonary disease. We assessed the predictive value of lung function measured in mid-life as compared with later life on arterial stiffness in the Caerphilly Prospective Study (CaPS).
Methods Men aged 47–67 years had lung function measured between 1984 and 1988 and repeated between 2002 and 2004 (n = 827) as well as having carotid-femoral pulse wave velocity (PWV) measured.
Results Both forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) in mid-life and later life were inversely associated with PWV (P < 0.0001) but mid-life measures were stronger predictors. Only mid-life measures remained predictors after mutual adjustment (FEV1 mid-life β coeff. –0.65, 95% CI –1.04, –0.26, P < 0.0001; FVC mid-life β coeff. –0.52, 95% CI –0.82, –0.23, P < 0.0001). Adjustment for smoking status, early life, inflammatory and metabolic factors in sub-groups did not markedly change the associations.
Conclusions Mid-life lung function is a stronger risk factor than in later life for arterial stiffness in men. It is possible that developmental factors influence both lung function and arterial stiffness. Lung function assessment in mid-life may identify individuals at greater risk of their future cardiovascular disease.
Keywords Epidemiology, cardiovascular disease, lung function, arterial stiffness
Accepted 18 December 2008